Ο ρόλος της σωματοστατίνης στην παγκρεατεκτομή

Abstract

Background: The postoperative morbidity following pancreatectomy remains high.The role of somatostatin and its analogues in reducing complications after pancreaticresection is controversial. It can inhibit the pancreatic secretions which, quite often,are responsible for complications during the postoperative period. The aim of thestudy was to evaluate the ability of somatostatin to influence pancreatic cell’sfunction with consequence the decrease of postoperative complications.Methods: Between January 2006 and December 2009 67 patients, for whichpancreatectomy was indicated, were randomized into two groups. In the studygroup (n=35), somatostatin was administered with continuous intravenous infusionperioperatively; before, during and after pancreatectomy. In the control group(n=32) no somatostatin was given perioperatively. Pancreatic tissues biopsies weretaken and processed for histological study with electron microscopy andultrastructural morphometric analysis.Results: The overall morbidity was 35.8% (24/67). Eighteen patients in the controlgroup (18/32; 56, 25%) and 6 patients in the treatment group (6/35; 17. 14%)developed postoperative complications (Fisher’s exact two-tailed test; p=0.001). Thetotal mortality was 4.4 % (2/67; 2 patients from the control group and 1 from thetreatment group). The most common complication was the presence of pancreaticfistula (6/67; 8.95%). The electron microscopy study of the pancreatic tissuespecimens revealed that the mean number of the secretory granules wassignificantly reduced in the treatment group compared to the control group (110.48±23.01 versus 139.51 ± 12.27; p=0.001).Conclusion: The perioperative administration of somatostatin for patientsundergoing pancreatic resection reduces the granule number and size of pancreaticcells. This finding supports the prophylactic effect of somatostatin on earlypostoperative complications of pancreatic surgery, shown in this study.